From guidelines to impact

Most global public health organizations issue guidelines that are of a high methodological quality and are developed through a transparent, evidence-based decision-making process. However, they often lack an effective, scalable mechanism to support governments and health workers at country and sub-country level in turning these into action that leads to impact.

Existing activities intended to help countries build public health capacity carry potential risk for these organizations, as they rely on high-cost, low-volume workshops and trainings that may be characterized by startling disparities in quality, scalability, replicability, and sustainability, often making it difficult or impossible to determine their impact.

In some thematic areas, stakeholders have recognized the problem and are developing their own frameworks to improve quality of training and improve capacity-building. A few stakeholders are experimenting with new capacity-building approaches to empower local actors and strengthen the resilience of communities.

The global community allocates considerable human and financial resources to training. The delivery of this training, however, has not kept pace with the increasing cost and complexity of global challenges.[1] Furthermore, a reductive focus on formal training is unlikely to lead to improvements in service delivery.[2]

Digital learning offers new ways to scale and open learning. However, existing digital learning platforms appear to be premised on the one-way transmission of knowledge – when it is the co-creation, adaptation, and application of knowledge that are needed to achieve double-loop learning – and from the center (HQ, capital city) to the periphery (countries, villages, volunteers). The transmitted knowledge is often abstract and decontextualized, while the value of existing local knowledge, practices and understanding is not recognized or incorporated into the learning experience.

Image: Personal collection. These levers control the diving planes which allow the vessel to pitch its bow and stern up or down to assist in the process of submerging or surfacing the boat, as well as controlling depth when submerged. USS Bowfin, a Balao-class submarine, was a boat of the United States Navy named for the bowfin fish. It is now stationed in Pearl Harbor, Honolulu, Hawaii, USA.